Vascular mechanics and pathology / Mano J. Thubrikar.

Format:

Book

Author/Creator:

Thubrikar, Mano.

Language:

English

Subjects (All):

Arteries--Pathophysiology.

Arteries.

Atherosclerosis--Pathophysiology.

Atherosclerosis.

Arteries--physiopathology.

Atherosclerosis--physiopathology.

Medical Subjects:

Arteries--physiopathology.

Atherosclerosis--physiopathology.

Physical Description:

xxiii, 494 pages : illustrations ; 24 cm + 1 CD-ROM (4 3/4 in.)

Place of Publication:

New York : Springer, [2007]

Summary:

Opening new doors for interdisciplinary research, Vascular Mechanics and Pathology establishes a correlation between vascular mechanics and pathology that could lead to the reduction of vascular diseases, as well as the development of new treatments.

Vascular Mechanics and Pathology focuses on the artery and arterial diseases. As the fundamental functions of the artery are to serve as a conduit of blood flow and as a container of blood pressure, Vascular Mechanics and Pathology describes both the general principles and the occurrence of stress concentration at the pressure vessel junctions and examines the role of beta-blockers in the reduction of atherosclerosis and related complications. This cutting-edge work presents the use of veins as arterial grafts and discusses the role of vein valves in graft stenosis. Vascular Mechanics and Pathology illustrates aneurysm formation, growth, and rupture, using pressure vessel principles. This new work details the investigation of, amongst other topics, aortic dissection, showing for the first time that the aortic root mechanics plays a vital role in the development of this pathology.

Key topics: Atherosclerosis, Structure and Mechanics of the Artery, Pressure Vessel Principles, Pressure Vessel Intersections, Stress Concentration in the Artery, Endothelial Cells and Low Density Lipoproteins at the Branch, Smooth Muscle Cells and Stretch, Stress Reduction and Atherosclerosis Reduction, The Vein Graft, Anastomosis, Anastomotic Aneurysms and Anastomotic Intimal Hyperplasia, Intracranial Aneurysms, Aortic Aneurysms, Aortic Dissection. Vascular Mechanics and Pathology is essential reading for cardiovascular researchers, surgeons, cardiologists, pathologists, radiologists, neurosurgeons, anatomists, students in biomedical engineering, and manufacturers of medical devices.

Contents:

Chapter 1 Atherosclerosis I 1

2 Geographic Variations 3

3 Natural History 4

4 Other Findings 5

5 The Pathogenesis of Atherosclerosis 6

5.1 The Fatty Streak 7

5.2 The Response-to-Injury Hypothesis of Atherosclerosis 7

5.3 Cellular Interactions in Atherosclerosis 8

5.4 When Does Atherosclerosis Begin 10

6 Risk Factors 11

6.1 High Serum Cholesterol and Low-Density Lipoprotein as a Risk Factor for CHD 11

6.2 Blood Pressure as a Major Cardiovascular Risk Factor 12

6.3 Cigarette Smoke Constituents and SMC Proliferation 13

6.4 Diabetes and Atherosclerosis 13

6.5 Obesity and Atherosclerosis 14

6.6 Effect of [Beta]-Blockade in Atherosclerosis 14

7 New Concepts 15

7.1 Parameters We Cannot Measure 15

7.2 Seeing Is Believing 16

7.3 Hemodynamics 16

7.4 Which Cell 17

7.5 Plaque Rupture, Atherosclerosis, Aneurysm 18

Chapter 2 Atherosclerosis II 20

1 Anatomical Distribution of Atherosclerosis 20

1.1 Atherosclerosis and Functions of the Artery 22

1.2 Stress-Concentration at the Arterial Branch Origins 22

2 Atherosclerosis and Stress-Concentration 24

2.1 Ostial Lesions and Stress-Concentration 24

2.2 Aortic Arch Lesions and Stress/Strain Concentration 25

2.3 Aortic Bifurcation Lesions and Stress 25

2.4 Carotid Bifurcation Lesions and Stress 27

2.5 The Descending Thoracic Aorta Lesions and Flexion Stress 29

2.6 Effect of Blood Pressure and Lesions in the Lower Extremities 30

3 Atherosclerosis in the Aortic Valve and Stress 31

3.1 Methodology 31

3.2 Findings 32

3.3 Stress Determination 35

3.4 Correlation with Stress 35

4 How Stress and Stretch Might Influence Atherosclerosis 36

5 Existing Concepts of Pathogenesis of Atherosclerosis 36

5.1 Response-to-Injury Hypothesis 37

6 A New Hypothesis for Pathogenesis of Atherosclerosis: Smooth Muscle Cell Injury Hypothesis 37

6.1 Essential Features 38

6.2 Cellular Mechanism of Atherosclerosis 38

7 Pathogenesis of Atherosclerosis and Aneurysm 39

7.1 Proposed Pathogenesis of Atherosclerosis and Aneurysm 40

Chapter 3 Structure and Mechanics of the Artery / Michel R. Labrosse 45

2 Composition of Arteries 47

3 Different Types of Arteries 48

4 Structure of Arteries 49

5 Macro- and Microstructural Changes Associated with Arterial Branches and Bifurcations 50

6 Function of Arteries 55

6.1 Baroreceptors 55

6.2 Effect of Posture 55

6.3 Adaptation to Pressure and Flow 56

7 Anchoring of Arteries, Residual Stress, and Smooth Muscle Activity 57

8 Changes Along the Arterial Tree 58

9 Aging 60

10 In Vivo Evaluation of the Mechanical Response of Arteries 61

11 In Vitro Evaluation of the Mechanical Response or Arteries 63

11.1 Uniaxial Tests 63

11.2 Biaxial Tests 64

11.3 Pressurization Tests 64

12 Mechanical Model 65

13 Determination of the Material Constants Associated with a Model 68

14 Finite Element Modeling of Arteries 69

15 Preliminary Study of Porcine Ascending Thoracic and Abdominal Aortas 71

Chapter 4 Pressure Vessel Principles 82

1 Equilibrium in the Artery Under Internal Pressure 83

1.1 Determination of Wall Stress in the Artery: The Basic Approach 83

1.2 Wall Stress in Different-Size Arteries 85

1.3 Magnitude of Wall Stress 86

1.4 Wall Stress in the Aortic Arch and Tortuous Arteries 86

1.5 Stress Distribution from Inside to Outside of the Artery Wall 87

2 Other Factors Affecting Wall Stress in the Artery 89

2.1 Tethering 89

2.2 Active versus Passive Conditions of the Artery 90

2.3 Residual Stress in the Circumferential Direction of the Artery 92

3 Circular Hole in a Plate Under Tension 93

3.1 Stress-Concentration Around a Circular Hole in a Plate Under Tension 94

3.2 Luder Lines 95

4 Stress-Concentration: Why Does It Occur? 96

4.1 Hole in a Plate 97

4.2 Geometric Discontinuity Stresses 98

4.3 Material Discontinuity Stresses or Stresses in a Bimetallic Joint: Stresses When the Material Changes While the Geometry Remains the Same 99

5 Hole in a Cylinder Under Internal Pressure 99

5.1 Elliptical Opening in a Plate 101

5.2 Elliptical Opening in a Cylinder 102

6 Techniques for Determination of Stress-Concentration 104

6.1 Strain Measurement 104

6.2 Photoelastic Method 104

6.3 Moire Method 105

Chapter 5 Pressure Vessel Intersections 107

1 Stress-Concentration at "T"-Branch Pipe Connection: The Area Method 108

1.1 Sample Calculation Using Area Method: An Example 111

2 Stress-Concentration of a Nozzle in a Spherical Vessel 112

2.1 Area Method 112

2.3 Influence Length 114

2.4 Effect of Bending (Stress-Concentration Correction Factor K[subscript b]) 115

2.5 Comparison with Shell Theory 115

3 An Elastic Shell Analysis of Stress-Concentration of a Pressurized "T"-Branch Pipe Connection 116

3.1 Structural Analysis of "T"-Branch Shell Intersection 118

4 Photoelastic Study of Stresses Around Reinforced Outlets in Pressure Vessels 119

4.1 Photoelastic Method 119

5 Nonradial Branch (Branch at an Angle) 122

6 Reinforcement Around the Branch 124

7 Fatigue at the Location of Stress-Concentration 126

8 Effect of Size of the Artery and Size of the Branch on Stress-Concentration 126

8.1 The Effect of Size of the Artery 127

8.2 The Effect of Size of the Branch (Hole) 128

8.3 Analytical Approach 128

9 Arterial Bifurcation 131

9.1 Discontinuity Stresses (Area Method) 132

9.2 Elliptical Cross Section at the Bifurcation 133

9.3 Bending in the Elliptical Cross Section 133

9.4 Stress Increase Due to Thickness Change 134

10 Curved Arteries 135

Chapter 6 Stress-Concentration in the Artery I 139

2 Stress-Concentration in the Bovine Coronary Arterial Branch 140

2.1 The Experiments 140

2.2 The Model 144

2.3 The Observations 145

3 Stress-Concentration in the Human Carotid Artery Bifurcation 148

3.1 The Geometry 149

3.2 The Analysis 151

4 Role of Residual Stress in Stress-Concentration at the Human Carotid Artery Bifurcation 154

4.1 Residual Strain 154

4.2 The Analytical Model 155

4.3 The Model Results 157

5 Stress at the Arterial Bifurcation Due to Vasoconstriction 160

5.2 Dete00rmination of Stress Due to Vasoconstriction 160

Chapter 7 Stress-Concentration in the Artery II 166

2 Shape Change at the Apex of Human Cerebral Artery Bifurcation Under Pressure 167

2.1 Study of the Apex of Cerebral Artery Bifurcation 167

2.2 Stress Considerations 170

3 Stress-Concentration at the Arterial Branch in Vivo 171

3.1 In Vivo Experiments 171

3.2 In Vitro Experiments 172

3.3 Geometry of the Branch 173

3.4 Theoretical Considerations 174

3.5 The Finite Element Model 176

3.6 Parametric Studies 177

3.7 Analytical Results 177

4 Determination of Absolute Values of Stress and Stress-Concentration at the Arterial Branch 182

4.2 Steps Used in the Analysis 183

4.3 Experimental Method 183

4.4 Isotropic Nonlinear Material Properties 186

4.5 Multiple Geometric Models 186

4.6 Changing the Modulus of Elasticity 186

4.7 Analytical Results 188

5 Stresses in the Human Aortic Arch: Analysis Using Nonlinear, Hyperelastic, and Isotropic Properties 192

5.2 Strains in the Human Aortic Arch 193

5.3 Determination of Stresses in the Human Aortic Arch 196

5.4 Results: Finite Element Model Solution 204

5.5 Verification of the Finite Element Model: Strain Comparison 210

6 Circumferential Stress in the Artery: Comparing Different Studies 211

Chapter 8 Endothelial Cells and Low-Density Lipoproteins at the Branch 214

2 Endothelial Cell Morphology at the Branch and Nonbranch Regions 216

2.1 Straight Segment 218

2.2 Branch Region 219

3 Endothelial Cell Morphology at the Site of High Permeability 220

3.1 Quantitation of Endothelial Injury 224

4 Changes in Endothelial Cell Shape Due to Imposed Coarctation 225

5 Changes in Aortic

Permeability Due to Imposed Coarctation 226

6 Endothelial Cell Orientation in the Aortic Valve 229

7 Changes in Endothelial Cell Morphology Due to Cyclic Tensional Deformation (Cell Culture Studies) 232

8 Endothelial Cell Orientation and Mechanical Forces 236

9 Distribution of Low-Density Lipoprotein in the Aorta 237

9.2 Distribution of LDL in the Rabbit Thoracic Aorta 237

10 Distribution of LDL in the Branch and Nonbranch Regions of the Aorta 239

11 Replication of Endothelial Cells and Its Preferential Localization 243

11.1 Areas Around the Mouths of Branches 244

11.2 The Effect of Constriction 245

12 Endothelial Cell Replication at the Site of Increased Permeability 246

12.1 Endothelial Cell Labeling 247

13 Endothelial Cell Replication Under Hypertension 248

13.1 Creation of Hypertensive Rats 249

13.2 Effects of Hypertension 249

14 Association Between Endothelial Cell Replication, Arterial Permeability, and Hypertension 249

14.1 Methods for Detecting Dying or Dead Endothelial Cells 251

14.2 Quantification of Immunoglobulin G-Containing Dying or Dead Endothelial Cells 251

14.3 Fluorescence Microscopy 251

Chapter 9 Smooth Muscle Cells and Stretch 255

2 SMC Proliferation and Hypertension 256

2.1 Changes in Arteries Proximal to Ligature 258

3 Response of SMCs to Cyclic Stretch: A Cell Culture Study 260

3.1 2D Cell Culture Studies 261

3.2 Cyclic Stretch and 3D Cultured SMCs 263

4 Artery Response to Balloon Injury and Cholesterol Diet: Contribution of SMCs 266

5 SMC Proliferation in Relation to Aortic Stretch 269

5.1 Autoradiography 270

5.2 Luminal Surface Area, Volume, and Weight of the Artery Segments 270

5.3 Change in the Aortic Diameter Due to Balloon Catheters 271

5.4 Effect of the Balloon Size 272

5.5 Effect of Tapering of the Aorta 273

5.6 Location of the Labeled SMCs 273

5.7 Aorta and Balloon Diameter 274

5.8 Balloon Injury and Cell Proliferation 274

5.9 Effect of Tapering of the Aorta 274

6 Quantitative Relationship Between SMC Proliferation and Aortic Stretch 275

Chapter 10 Stress Reduction and Atherosclerosis Reduction 281

2 Inhibition of Atherosclerosis by Reduction of Arterial Wall Stress 282

2.1 Reduction of Arterial Wall Stress 282

2.2 Rabbit Model for Atherosclerosis 283

2.3 Atherosclerosis in Control and Stress-reduced Areas 285

3 Rhythmic Pattern of Atherosclerosis in Vertebral Arteries 288

4 Freedom from Atherosclerosis in Intramyocardial Coronary Arteries 290

4.1 The Anatomy 290

4.2 Clinical Investigation 292

4.3 Studies in Canine Hearts 292

4.4 Wall Stress and Coronary Atherosclerosis 295

5 Change in Endothelial Cell Morphology by Reduction of Arterial Wall Stress 296

6 Cumulative Arterial Injury Hypothesis for Atherosclerosis 298

6.1 Wall Stress and Atherosclerosis 299

6.2 Cumulative Arterial Injury (Artery Fatigue) and Atherosclerosis 300

6.3 Endothelial Injury and Atherosclerosis 303

6.4 Medical Injury and Atherosclerosis 303

6.5 Comprehensive Mechanism for Atherosclerosis 303

7 Comparing Fatigue Damage Between Nonbiological (Metallic) and Biological Pressure Vessels 304

7.1 Common Cause of Atherosclerosis and Aneurysm 304

7.2 Stress-Concentration and Fatigue 305

8 Reduction of Coronary Atherosclerosis by Reduction of Heart Rate in Cynomolgus Monkeys 307

9 Reduction of Atherosclerosis by Treatment with Beta-Blocker in Cynomolgus Monkeys 308

10 Reduction of Endothelial Cell Injury by Treatment with Beta-Blocker in Cynomolgus Monkeys 310

11 Reduction of Arterial Permeability to LDL by Treatment with Beta-Blocker in Rabbits 313

11.1 LDL Preparation 313

11.2 Aorta Preparation and the Experiment 313

11.3 Tissue Samples, Cryosectioning, and Counting 314

11.4 Heart Rate 314

11.5 Aortic Wall Thickness 314

11.6 LDL Influx 314

11.7 Summary and Interpretation 316

Chapter 11 The Vein Graft 320

1.1 Veins from the Lower Leg 321

1.2 Shape of the Vein versus Vein Graft 321

1.3 Vein Valves 322

1.4 Reversed, Nonreversed, and in Situ Grafts 322

2 Vein Graft Atherosclerosis in Coronary Artery Positions 323

3 Etiology of Lesions in the Vein Grafts 325

4 Vein Grafts in Femoro-Popliteal Positions 327

4.1 Additional Comments 329

5 Vein Valves and Graft Stenosis 330

5.1 The Animal Model 331

5.2 The "Horseshoe" Graft in Patients 332

6 Vein Valve Motion and Pressure Trap in Vein Grafts 333

6.1 The Fate of the Vein Valve in the Graft 334

6.2 Flow Augmentation by the Vein Valve in the Graft 335

6.3 Valve Motion and Pressure Trap 335

6.4 Pressure Trap in Patients 341

7 Valve Motion in Coronary Artery Bypass Graft: Correlation with Flow Waveform 344

7.1 Valve Dynamics in the Femoro-Popliteal Position 350

8 Mechanics of Distension of Veins 351

9 Adaptation of the Vein in the Arterial Position 354

9.1 Jugular Vein in Carotid Position in Rabbits 354

9.2 Adaptation of Vein Under Various Pressure and Flow Conditions 357

9.3 Intimal and Medial Changes in Vein Grafts in Response to Pressure and Flow 358

10 Adaptation of Vein Grafts Under External Support 359

10.1 Perivenous Mesh 360

10.2 A New Outside Stent 362

10.3 Biodegradation of External Support to Optimize Arterialization of Vein Grafts 364

Chapter 12 Anastomosis 368

2 Increased Compliance Near Artery-to-Artery, End-to-End, Anastomosis 369

3 Influence of Interrupted versus Continuous Suture Technique on Compliance Near an Anastomosis 371

4 Arterial Anastomosis with Vein and Dacron Grafts: Stress Studies 373

Chapter 13 Anastomotic Aneurysms and Anastomotic Intimal Hyperplasia 380

2 Anastomotic Aneurysms 381

2.1 Clinical Findings 383

2.2 Pathogenesis 384

3 Mechanical Stress at Prosthesis-to-Artery, End-to-Side Anastomosis 386

4 Anastomotic Intimal Hyperplasia 388

4.1 Vein-to-Artery, End-to-Side Anastomosis 388

4.2 Effect of Graft Compliance Mismatch on Arterial Intimal Hyperplasia at the Anastomosis 392

4.3 Suture Line Stresses at the Anastomosis: Effect of Compliance Mismatch 396

4.4 A Take-Home Message 402

Chapter 14 Intracranial Aneurysms 403

2 The Anatomy 404

3 Incidence 405

4 Pathology 407

4.1 Aneurysms 407

4.2 Atherosclerosis 411

4.3 Association Between Aneurysm and Atherosclerosis 413

5 Mechanism of Aneurysm Formation 414

5.1 Pathogenesis of Aneurysms 416

5.2 Mechanisms of Growth and Rupture 418

5.3 Aneurysm Wall Histology 419

6 Elasticity of the Aneurysm 419

7 Mechanical Forces in Aneurysm Formation 421

7.1 Fluid Dynamics-related Forces 421

7.2 Solid Mechanics-related Forces 423

Chapter 15 Aortic Aneurysms 426

2 Incidence of AAA 427

3 Association Between Aneurysm Size and Rupture 429

4 Pathogenesis of Aortic Aneurysm 431

4.1 Histology/Morphology 431

4.2 Other Contributing Factors 435

5 Expansion Rate of AAA 436

6 Thrombus and AAA 437

7 Location of Rupture in AAA 439

8 Effect of Thrombus on AAA Dilation and Stress 440

8.1 Pressure Transmission Through the Mural Thrombus 441

8.2 AAA Dilation Under Intraluminal Pressure 442

8.3 Mechanical Model of the Thrombus 444

8.4 Clinical Significance of Thrombus in Aneurysm 445

9 Mechanical Properties and Rupture Strength of AAA 446

9.1 Comparing Different Regions 449

9.2 Comparing Different Directions 449

10 Changes in Wall Stress During Growth of the Aneurysm 451

10.1 Material Properties of the Normal Aorta 452

10.2 Geometry of the Aneurysm Model 453

10.3 Finite Element Analysis of the Model 454

10.4 Overall Finding 456

10.5 Justification of the Model 456

10.6 Orientation of Tear 457

11 Wall Stress in AAA 457

11.1 The Approach 458

11.2 Observations 459

11.3 The Implications 465

Chapter 16 Aortic Dissection 469

1 Morphologic Features 469

2 Incidence 471

3 Predisposing Factors 472

4 Classification, Location, Frequency 472

5 Pathogenesis 473

6 The Role of Aortic Root Motion in the Pathogenesis of Aortic Dissection 474

6.1 Measurement of Aortic Root Motion in Patients 474

6.2 Stress Analysis of the Aortic Root, Aortic Arch, and Supra-aortic Vessels 475

6.3 Significance of Aortic Wall Stress 482.

Notes:

Includes bibliographical references and index.

ISBN:

0387338160

9780387338163

OCLC:

123962874